Literature Review

A whistleblower lawsuit cost ChristianaCare $47M. Why are whistleblower cases increasing? Delaware Online, by Esteban Parra and Xerxes Wilson; 3/4/24A former medical director specializing in neurosurgery at southern Delaware’s largest health care provider claims in a lawsuit that Bayhealth Medical Center misclassified “brain-dead” patients in order to overbill for services. ... [The whistleblower reported that] hospital officials discussed a "new hospital initiative" in which suspected "brain-dead" patients would be discharged and admitted to hospice before any declaration of brain death, according to the lawsuit. The scheme allowed for prolonged billing where previous billing ended with the patient’s death, the complaint states. [Please refer to the article for details.]

Revolutionizing Elderly Care: Palliative Care's growth and integration into Value-Based ModelsBNN, by Olalekan Adigun; 3/5/24Amid the rapidly evolving landscape of healthcare, palliative care is undergoing a significant transformation, marking a new era in the management and delivery of healthcare services to the elderly. Dr. Jason Black, a seasoned family medicine practitioner with a specialized fellowship in geriatrics, is at the forefront of this change. Working for Gilchrist, a hospice and palliative care organization in Baltimore and central Maryland, Dr. Black embodies the integration of palliative care into the broader healthcare framework, emphasizing value-based care models.

Physicians grow louder on noncompetes Becker's Hospital Review, by Ashleigh Hollowell; 3/4/24 Amid a nationwide shortage of physicians, contractual noncompete clauses are making it more challenging for patients to receive the care they need, particularly in more rural regions, and physicians are pushing back, NBC News reported March 3. The American Medical Association estimates that between 35% and 45% of physicians in the U.S. are bound by noncompete clauses of some kind.

Coverage denials in Medicare Advantage—Balancing access and efficiencyJAMA Health Forum; by Suhas Gondi, MD, MBA; Kushal T. Kadakia, MSc; and Thomas C. Tsai, MD, MPH; 3/1/24 Each year, millions of claims for medical services are denied by health insurance plans. Many denials may be justified as a necessary strategy to reduce wasteful spending from low-value care. However, denials may also delay diagnosis and/or treatment for patients, and appealing denials contributes to clinician workload and burnout. This tension is apparent in the Medicare program, where denials affect millions of beneficiaries who enroll in Medicare Advantage (MA). 

Providers meet with OMB to prevent ‘devastating’ effect of 80/20 provision McKnights Home Care, by Adam Healy; 3/4/24Home care stakeholders have been busy on Capitol Hill voicing concerns about a controversial provision of the proposed Medicaid Access Rule. The National Association for Home Care & Hospice and Home Care Association of America met with the Office of Management and Budget last week to discuss the Access Rule’s so-called 80/20 provision. The provision, if finalized, would require that 80% of Medicaid payments for personal care, home health and homemaker services be spent on workers’ compensation. “If that one provision is finalized as proposed, it would be so detrimental that we’d likely lose a significant portion of our service delivery base and people would go without care,” Damon Terzaghi, NAHC’s director of Medicaid HCBS (home- and community-based services) said in an interview with McKnight’s Home Care Daily Pulse. “It would truly be devastating.”

Be yourself; everyone is already taken. - Oscar Wilde

The current state of community-based palliative careHospice News, by Jim Parker; 3/4/24“Palliative care” is becoming a buzz word in health care, even if many people don’t understand the loosely defined term. However, wide variation exists in how different providers deliver these services in the absence of a standardized, national definition or a more concrete regulatory structure that includes quality measures, Logan Hoover, vice president of policy and public relations for the National Hospice and Palliative Care Organization (NHPCO), said at the Hospice News Palliative Care Conference in Tampa, Florida.

Man’s dying wish was to see newest ‘Dune’ film. Director made it happen before release Global News, by Alessia Simona Maratta; 3/4/24 A palliative care patient’s end-of-life wish was to see the second installment of Denis Villeneuve’s Dune before he passed. The Quebec filmmaker and his team rushed to make it happen almost two months before the film’s premiere and just days before the man died. 

APRNs, home health / personal care aides top healthcare careers in 2024 McKnights Senior Living, by Kathleen Steele Gaivin; 2/28/24Advanced practice registered nurses and home health and personal care aides lead the list of top healthcare careers in 2024, according to a study from digital healthcare platform Tebra. The researchers compared 46 healthcare industry jobs by median pay, 10-year outlook and expected job growth, employment per 10,000 workers and web search volume, using data from the Bureau of Labor Statistics and the Census Bureau. ... Among all healthcare occupations included in the study, ones in home care had the highest employment rate. 

Profits at hospice firm VITAS soar by whopping nearly 88 percent in Q4 McKnights Home Care, by Adam Healy; 2/29/24Hospice firm VITAS, a subsidiary of Chemed, enjoyed a stellar fourth quarter as profits rose by nearly 88% to reach $63 million. It helped to buoy Chemed’s overall earnings as the parent company’s other subsidiary, plumbing subsidiary Roto-Rooter, struggled with weaker profits and sales. 

Contract CNA staffing associated with worse care quality outcomes: study McKnights Senior Living, by Kathleen Steele Gaivin; 3/1/24Nursing homes that use contract staffing to fill certified nursing assistant position vacancies are more likely to experience worse care quality than those that do not, according to the results of a study by PHI. The proportion of total CNA hours filled by contract CNAs in SNFs increased from 2% in 2017 to 11% in 2022, the study found.

Colorado’s medical aid-in-dying residency requirement won’t be lifted The Colorado Sun, by Jesse Paul; 3/1/24 Out-of-state residents will continue to be prohibited from receiving medical aid in dying in Colorado after a bill aimed at loosening the regulations for terminally ill people seeking to end their lives was pared back Thursday evening. Senate Bill 68 was also changed to shrink the waiting period for people seeking medical aid in dying to seven days from 15, with the possibility to eliminate the waiting period for people who may not have 48 hours to live. 

Pharmacy associations join forces to advocate for pharmacists during change healthcare outageNewswire Press Release; 3/3/24 Association executives from the American Pharmacists Association (APhA), the National Community Pharmacists Association (NCPA), the National Alliance of State Pharmacy Associations (NASPA), and the American Society of Consultant Pharmacists (ASCP) released an open letter to pharmacy benefit manager (PBM) executives and other insurance payers whose systems may have been impacted by the Change Healthcare outage. Pharmacists and pharmacies are asking for assurances that claims fulfilled during this outage will be paid, and paid in a timely manner, considering the challenges faced by pharmacies and pharmacists with predicting co-payments and determining eligibility and coverage.